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Culture ClashHow We Win the Battle for
Better Health
PART I
Dr. Steven AldanaCEO WellSteps
Four Part Agenda
Part I. What’s the ProblemPart II. How Our Culture Has ChangedPart III. Culture is the Cause: A New Culture is the SolutionPart IV. How to Create a New Culture By Creating Islands of
Health
Percent of Americans Who Are Obese
Percent of Americans Who Are Obese
Estimated
Obesity by State 2009
Diabetes Prevalence 1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Life Expectancy
New Normal
New Normal
• Talking to me?• Talking to yourself?• Talking to someone else?
New Normal
New Normal
Burrito Grande
What is the Problem?
• Our food and activity patterns have changed• Our nation’s health is poor and getting worse• Individuals are dying prematurely and quality of life
is declining• Health care costs continue to increase which creates
a burden to employers
How Do We Fix the Problem?
1. We need to know what is causing these changes.2. We need to address the direct cause.
What is Causing These Changes?
• Genetics?• Environmental toxins or chemicals?• Something in the air or water?• Changes to our culture?• Something else?
It’s Our Culture
Proof It’s Our Culture:
Percent of Adults Overweight
USA
England
Canada
Austria
France
Korea
Percent of Adults Overweight
USA
England
Canada
Austria
France
Korea
Brazil
“It is actually cheaper to eat fast food than cook healthy food at home here. There is now an
overrepresentation of cheap fast food in the region which is driving our diabetes epidemic.”
Dr. DarwicheRashid Center for DiabetesUnited Arab Emirates
Ranking Country Cases of Diabetes(in millions)
1 India 31.72 China 20.83 U.S. 17.04 Indonesia 8.45 Japan 6.86 Pakistan 5.27 Russian Federation 4.68 Brazil 4.69 Italy 4.3
10 Bangladesh 3.2
Ranking Country Cases of Diabetes(in millions)
1 India 31.72 China 20.83 U.S. 17.04 Indonesia 8.45 Japan 6.86 Pakistan 5.27 Russian Federation 4.68 Brazil 4.69 Italy 4.3
10 Bangladesh 3.2
The Dark Side of Capitalism
New Exposure
Greater Exposure Rates
Lifetime Risk of Diabetes for Children Born in 2000
35%
43%
0%5%
10%15%20%25%30%35%40%45%50%
White Black Hispanic
Venkat Narayan, JAMA 2003;290:1884
49%
Diabetes Among the Pima
One-half of adult Pima Indians have diabetes and 95% of those with diabetes are overweight.
Am. J. Epidemiol. (1978) 108 (6):497-505.
Proof Summary:
• Greater exposure to a Western culture is associated with greater obesity and diabetes
• Rapid acculturation is associated with rapid declines in health
• Health worsens faster for those who were healthiest to begin with (Pima)
Quiz
How old is the human race?
a) 6,000 years oldb) 10,000 years oldc) 100,000 years oldd) 1,000,000 years old
Two parts to this problem:
• Unhealthy culture• Our ancient physiology
60,000 BC
100,000 BC
present
100,000 BC
present
100,000 BC
present
100,000 BC
present
100,000 BC
present
100,000 BC
present
Milk
100,000 BC
present
MilkSugar
100,000 BC
present
Milk
HFCS
Sugar
100,000 BC
present
What did they eat and how do we know?
1. Look at people who are still hunters and gatherers2. Study the remains and living environments of
Paleolithic peoples3. Study the bones of our ancestors
• +/- 50% wild game (35-70%)• +/- 50% plants
More hunting than gathering.Meat then was different than today’s meat.
Today’s meat is different:
• Steroids• Growth hormone• Antibiotics• Feed lots fed• Genetically manipulation• More saturated fat
What about today’s plants and food?
• Whole grains, refined grains• Herbicides and insecticides• Dairy• Cheese• Salt, Sugar, and Fat
Lucky Charms:
Oat flour, marshmallow bits (sugar, modified corn starch, corn syrup, dextrose, gelatin, calcium carbonate, yellow 5&6, blue I, red 40, artificial flavor), sugar, corn syrup, corn starch, salt, calcium carbonate, color added, trisodium phosphate, zinc and iron (mineral nutrients), vitamin C (sodium ascorbate), a B vitamin (niacinamide), artificial flavor, vitamin B6 (pyridoxine hydrochloride), vitamin B2 (riboflavin), vitamin B1 (tiamin mononitrate), vitamin A (palmitate), a B vitamin (folic acid), vitamin B12, vitamin D, wheat starch, vitamin E (mixed topopherols) added to preserve freshness
Modern Discord: Culture Clash
• We have ancient bodies• We live in a modern world• Our bodies have not had enough time to adapt• Adaptation is a slow process
– European descent vs native populations
Maladaption
• Hypercholesterolemia• Hypertension• Hyperglycemia• Osteoporosis• Chronic diseases including Alzheimers
Medications
Treatment Protocol
1. TLC (Therapeutic Lifestyle Change)2. Medications
Most physicians don’t believe patients are able to change lifestyles.
Percent of Adults Overweight
USA
England
Canada
Austria
France
Korea
Brazil
Common Questions:
• Are we sure it’s our culture?• Are we confident we know what our ancestors ate?• Who want’s to live like a caveman?• Humans are living longer, how can there be a
problem with our health?• Isn’t this just your opinion?
Summary
• Our health is getting worse• Our culture is the most likely culprit• There is nothing we can do to speed up human
adaptation• Since we cannot change our genetics, the only thing
we can change is our culture and environment
Up next.. Part II How Our Culture Has Changed
• We will discuss the only realistic solution to our poor health
• We will learn how and why our current culture has changed.
• We will understand the different pieces of our unhealthy culture and how to avoid or replace them